A voters guide to the health of the presidential candidates

WASHINGTON — How much do you know about the health of presidential candidates — and whether they’re actually up to the job of running the country?

It’s a serious question in most presidential races, but it could be even more serious in this one. That’s partly because of the age of some of the leading contenders.

But it’s also an issue that the campaigns have raised, in ways that are both subtle and not. Republicans see Marco Rubio’s youth (he would be 45 when he took office) as a virtue. Donald Trump has boasted of his own health and taunted Hillary Clinton by claiming she doesn’t have the “stamina” to be president.

Some current and former candidates have disclosed some health conditions already. Ben Carson battled prostate cancer in 2002; Carly Fiorina was diagnosed with breast cancer in 2009; and Clinton suffered a concussion in 2012.

Others have kept their medical records private.

Here’s a guide to the issues to watch when the spotlight turns to the presidential candidates’ health:

The age of the candidates

This year’s presidential field has an unusual number of top contenders who are in their golden years.

Trump, at 69, is as old as Ronald Reagan was when he was first elected president. Clinton is 68, and Bernie Sanders is 74. Carson is 64.

It’s not unusual to have some presidential candidates on the older side. John McCain was 72 when he ran against 47-year-old Barack Obama in 2008. Bob Dole was 73 in 1996, when he tried to defeat 50-year-old Bill Clinton’s bid for a second term.

But the older candidates are usually limited to one party or the other, not both.

Clinton’s concussion

Clinton’s health scare occurred when she fell and hit her head in December 2012, while she was secretary of state. She suffered a concussion and double vision, and had to wear special glasses to minimize the effects of the double vision. A letter from her physician, Dr. Lisa Bardack, said those symptoms disappeared after two months. But she also had a blood clot near her brain — transverse sinus venous thrombosis — that had to be dissolved with blood thinners.

She still takes the blood thinner Coumadin (warfarin) every day, according to the letter — a medication that has to be monitored extremely closely, since the dosage has to be almost perfect to avoid serious problems like bleeding or clots. Bardack insists that Clinton’s dose is “monitored regularly.”

In her letter, she also noted that Clinton had deep vein thrombosis twice, in 1998 and 2009 — a potentially serious condition because the blood clots can break loose and move up into the lungs.

It wasn’t long ago that Karl Rove attempted to suggest Clinton might have suffered brain damage after her fall. That effort did not end well for him.

Sanders’s medical history

Sanders had a hernia repair procedure in November at George Washington University Hospital in Washington. It was an outpatient procedure, and he was back voting in the Senate a few days later.

Sanders, who is older than Reagan, Dole, and McCain were during their presidential campaigns, is in “overall very good health,” according to a letter from the Capitol physician, Dr. Brian Monahan. Among other things, the letter says Sanders has had gout, a form of arthritis, and a “mild” case of high cholesterol. He also takes takes levothyroxine — a medication that’s used to treat hypothyroidism — every day, and occasionally takes an anti-inflammatory drug called indomoethacin.

Carson’s cancer

In 2002, Carson had surgery for prostate cancer. The procedure was a radical prostatectomy — what the surgeon described as the “complete removal of the prostate and seminal vesicles,” the Washington Post reported at the time.

This week, however, the Wall Street Journal raised the possibility that Carson might have had a recurrence of the cancer in 2009.

Carson declined to provide further details, telling the Journal, “I really don’t want to get into all my personal health issues with you. I don’t think that’s appropriate.”

Fiorina’s cancer

Fiorina, who dropped out of the race after a disappointing finish in New Hampshire, talked openly about her battle with breast cancer.

She underwent a double mastectomy in 2009 and campaigned with short hair when she ran for the Senate that year. In her book, “Rising to the Challenge,” she also recalled a painful complication during the closing days of the campaign in 2010: an infection of one of the implants from her reconstructive surgery. “My entire left side was on fire,” she wrote.

In a November debate, she mentioned the episode as she sought to relate to voters who might doubt her experiences as a patient when she’s criticizing Obamacare. “Look, I’m a cancer survivor, OK? I understand that you cannot have someone who’s battled cancer just become known as a pre-existing condition,” she said. But she didn’t release any recent health histories from her doctors to detail her current health status.

Family histories

Candidates’ family health histories don’t always factor in campaigns. But sometimes candidates raise these issues on their own, in part to relate to voters.

Among the candidates this campaign, we know of several instances of serious disease. Trump’s father, Fred C. Trump, had Alzheimer’s disease when he died in 1999. So does Carson’s mother, Sonya Carson, according to the Washington Post. Clinton’s father, Hugh Rodham, died of a stroke, and her mother, Dorothy Rodham, had congestive heart failure when she passed away, according to the physician’s letter.

Jeb Bush has revealed that his mother-in-law, Josefina Gallo Esquivel, has Alzheimer’s disease — an experience he cited in an email exchange with Maria Shriver earlier this year as a reason for his calls for more medical research funding and faster federal approval of new drugs.

How much transparency?

It remains an open question how much more we’ll learn about candidates’ health conditions.

The other campaigns aren’t promising that they’ll release health records at all.

Carson’s campaign has been noncommittal about releasing his health records. Fiorina spokeswoman Anna Epstein said simply, “She is cancer-free. We have not released health records.” Other campaigns didn’t respond to inquiries.

Even the candidates who have released information about their health already have provided varying degrees of detail. Clinton, Sanders, and Bush all summarized their health histories through letters from their physicians, rather than by releasing detailed medical reports. All declared them healthy, of course.

Clinton’s letter did describe the concussion and the medications she has been taking since then, but it also said she was in “excellent physical condition.” A letter for Bush called him “a healthy and vigorous 62-year-old man,” but it also noted that his medical history includes “vitamin D insufficiency, gastritis, colon polyps, sinusitis, and low-back pain.”

So far, the younger candidates have been careful about raising age or health as an issue directly. Political strategists, however, say age is likely to come up one way or another.

“My guess is, Clinton, in the course of this election, will likely have to answer a question … that says, ‘Look you’re going to be the same age as Ronald Reagan. As we now know, regardless of when it started, he started suffering from early effects of Alzheimer’s. Would you submit to a cognitive test?'” said Carter Eskew, a Democratic strategist who was a senior adviser to Al Gore’s 2000 presidential campaign.

He said, however, there’s an antidote for Clinton: “I just don’t get any sense of someone who is slowed in any way by age.”

Dylan Scott and Ike Swetlitz contributed to this report.

This story has been updated. New information about the candidates’ health will be added as it becomes available.